HIAWATHA HARRIS MD INC. NPI 1942420724

NPI Information

NPI: 1942420724
Provider Name: HIAWATHA HARRIS MD INC.
Classification: Counselor - 101YM0800X
Specialization: Mental Health
Entity Type: Organization
Doing Business As: PATHWAYS TO WELLNESS, MEDICATION CLINIC
Address: 1970 BROADWAY STE 250
OAKLAND, CA
ZIP 94612
Phone: (510) 273-4200

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NPI Details

HIAWATHA HARRIS MD INC. is a mental health counselor in Oakland, CA. HIAWATHA HARRIS MD INC. NPI is 1942420724. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pathways To Wellness, Medication Clinic.

The provider's business location address is:

1970 BROADWAY STE 250
OAKLAND, CA
ZIP 94612-214
Phone: (510) 273-4200
Fax: (510) 273-8340

The provider's authorized official is Neisha Becton .
The authorized official title is Ceo and has the following contact phone number (925) 520-0005.

The enumeration date for this NPI number is 4/26/2007 and was last updated on 8/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	C22371	CALIFORNIA	Yes
2	103TF0000X	Psychologist	Family	C22371	CALIFORNIA	No
3	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	C22371	CALIFORNIA	No
4	106H00000X	Marriage & Family Therapist		C22371	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01AG	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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